Women, Heart Disease and Stroke

Heart disease isn’t just a man’s disease. Heart attack, stroke and other cardiovascular diseases are devastating to women, too.

In fact, coronary heart disease, which causes heart attack, is the single leading cause of death for American women.

Many women believe that cancer is more of a threat, but they’re wrong. Nearly twice as many women in the United States die of heart disease, stroke and other cardiovascular diseases as from all forms of cancer, including breast cancer.

The American Heart Association has identified several factors that increase the risk of heart disease and stroke. The more risk factors a woman has, the greater her risk of having a heart attack or stroke.

Some of these risk factors you can’t control, such as increasing age, family health history, and race and gender. But you can modify, treat or control most risk factors to lower your risk.

What are the risk factors for heart disease and stroke that you can’t control?

Increasing age — As women grow older, their risk of heart disease and stroke begins to rise and keeps rising with age.

Sex (Gender) — Men have a greater risk of heart attack than women, and they have attacks earlier in life. Each year about 55,000 more women than men have strokes, and about 60 percent of total stroke deaths occur in women.

Heredity (family history) — Both women and men are more likely to develop heart disease or stroke if their close blood relatives have had them. Race is also a factor. Black women have a greater risk of heart disease and stroke than white women. Compared with whites, African-American men and women are more likely to die of stroke.

Previous heart attack or stroke or TIA — Women who’ve had a heart attack are at higher risk of having a second heart attack; 22 percent of women ages 40 to 69 who survive a first heart attack will have another heart attack or fatal coronary heart disease within five years, and 22 percent ages 40 to 69 who survive a first stroke will have another within five years. A transient ischemic attack (TIA or “mini-stroke”) also is a risk factor and predictor of stroke.

What risk factors can be modified, treated or controlled by focusing on lifestyle habits and taking medicine, if needed?

Tobacco smoke — Smoking is the single most preventable cause of death in the United States. Smoking is a major cause of cardiovascular heart disease among women.

Women who smoke have an increased risk for ischemic stroke and subarachnoid hemorrhage. Constant exposure to others’ tobacco smoke (secondhand smoke) at work or at home also increases the risk, even for nonsmokers. Women smokers who use birth control pills have a higher risk of heart attack and stroke than nonsmokers who use them.

High blood cholesterol — High blood cholesterol is a major risk factor for heart disease and also increases the risk of stroke. Studies show that women’s cholesterol is higher than men’s from age 55 on. High levels of LDL (low-density lipoprotein) cholesterol (the “bad” cholesterol) raise the risk of heart disease and heart attack. High levels of HDL (high-density lipoprotein) cholesterol (the “good” cholesterol) lower the risk of heart disease.

Research has shown that low levels of HDL cholesterol seem to be a stronger risk factor for women than for men.

High blood pressure — High blood pressure is a major risk factor for heart attack and the most important risk factor for stroke. Women have an increased risk of developing high blood pressure if they are obese, have a family history of high blood pressure, are pregnant, take certain types of birth control pills or have reached menopause. African-American women have higher average blood pressure levels compared to Caucasian women.

Physical inactivity — Various studies have shown that lack of physical activity is a risk factor for heart disease and indirectly increases the risk of stroke. Overall, they found that heart disease is almost twice as likely to develop in inactive people than in those who are more active.

When you’re inactive and eat too much, you can gain excess weight. In many people overweight can lead to high blood cholesterol levels, high blood pressure, diabetes and increased risk of heart disease and stroke. The American Heart Association recommends accumulating at least 30 minutes of physical activity on most or all days of the week.

Obesity and overweight — If you have too much fat — especially if a lot of it is located in your waist area — you’re at higher risk for health problems, including high blood pressure, high blood cholesterol, high triglycerides, diabetes, heart disease and stroke.

Diabetes mellitus — Adults with diabetes have have heart disease death rates that are two to four times those of adults without diabetes. People with diabetes often have high blood pressure and high cholesterol and are overweight, increasing their risk even more.

What other factors contribute to the risk of heart disease and stroke in women?

High triglyceride levels — Triglyceride is a common type of fat in the body. A high triglyceride level often goes with higher levels of total cholesterol and LDL, lower levels of HDL and increased risk of diabetes. But scientists don’t agree that it’s a risk factor for heart disease by itself.

Research suggests that having high triglycerides may increase the risk for women more than for men.

Excessive alcohol intake — The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women per day) is lower than in nondrinkers.

However, it’s not recommended that nondrinkers start using alcohol or increase the amount they drink. Excessive drinking and binge drinking can contribute to obesity, high triglycerides, cancer and other diseases, raise blood pressure, cause heart failure and lead to stroke. Pregnant women should not drink alcohol in any form.

Individual response to stress — Research hasn’t yet defined the role stress plays in the development of heart disease. People respond differently to situations they find stressful. Unhealthy responses to stress may lead to other risk behaviors like smoking and overeating.